AEGiS-14IAC: First suggestion of a decline in HIV prevalence in Zimbabwe.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

First suggestion of a decline in HIV prevalence in Zimbabwe.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. LbPeC9034)

Kububa P, Dube L, Midzi SM, Nesara P, St. Louis ME
Ministry of Health, Harare, Zimbabwe

BACKGROUND: Zimbabwe has experienced a severe generalized HIV epidemic, and the aggregate HIV prevalence in HIV surveillance in antenatal care centers (ANC) in 2000 was 35%.

METHODS: To monitor progress in response to the epidemic, ANC surveillance was repeated in 2001 in 19 designated HIV sentinel sites. Up to 500 consecutive leftover blood specimens from women tested for syphilis at first booking for pregnancy were tested for HIV in an anonymous, unlinked fashion. ANC sites included rural, urban, commercial farming, mining and border sites. Testing for HIV antibody was by the BioRad Genscreen 1-2 Kit. Data were analysed using Epiinfo 2000 and SAS.

RESULTS: 6790 specimens were available; 60% were from women <25 yrs and 55% from rural areas. HIV prevalence varied little by urban and rural status, by marital status, education, or most other demographic variables other than age. Comparing 2001 to 2000, the HIV positivity rates were: all ages: 29.5% compared to 35%; 15-19 yrs: 19% vs. 27%; 20-24 yr: 29% vs. 35%; 25-29 yrs: 37% vs. 40%; 30-34 yrs: 40% vs 44%; 35-39: 31% vs. 31%. Two ANC sites had absolute prevalence declines between 2000 and 2001 of great than 25%, which is questionable; repeating the analysis without those two sites dropped the overall decline by half, but the same pattern of greatest apparent decline in the younger groups was sustained.

CONCLUSIONS: These data represent the first suggestion of any decline in HIV prevalence in Zimbabwe, although the absolute magnitude of the difference observed between 2000 and 2001 appears too large to be attributed to a true decline. Even though the suggested trend urgently needs to be confirmed, the greater proportionate changes in HIV prevalence in the younger age groups is consistent with onset of a true decline. Confirmation of this apparent trend toward declining HIV prevalence is of highest priority, and prevention efforts need to be re-doubled.

Keywords: AEGIS, Prevalence, HIV, HIV Infections, HIV Seropositivity, Zimbabwe, HIV Seroprevalence, HIV Antibodies, Prenatal Care, Disease Outbreaks, Syphilis, Human, Female, Pregnancy, epidemiology, immunology

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